Frontiers in Cardiovascular Medicine最新文献

{"title":"Pulmonary artery rupture by pulmonary artery catheter in cardiac surgery: a case report and review of literature.","authors":"Yuta Nakamura, Keita Saku, Suzu Homma, Yoko Midorikawa, Tsuyoshi Yamabe, Takashi Ota","doi":"10.3389/fcvm.2025.1567723","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1567723","url":null,"abstract":"<p><p>The pulmonary artery catheter (PAC) is widely used in cardiac surgery for monitoring hemodynamics and cardiovascular function. Complications including pulmonary artery injury causing massive intratracheal hemorrhage are rare but can be life-threatening. We report a case of intratracheal bleeding (3,000 ml) caused by PAC-induced pulmonary artery injury during cardiac surgery and after weaning from cardiopulmonary bypass (CPB). During surgery for acute type A aortic dissection followed by CPB weaning, pulsatile bleeding from the endotracheal tube and desaturation were observed. We reinstituted CPB and placed a right-sided double-lumen tube to compress the injured site of the lung and protect the contralateral site. Following initial bleeding control, we conducted coil embolization to treat tracheal obstruction by a pseudoaneurysm on day 7. A review of 21 recent cases of pulmonary artery injury during cardiac surgery showed that most cases occurred during CPB weaning, manifested hemoptysis, and were treated by coil embolization. This case underscores the importance of enhanced PAC monitoring even after CPB weaning and the need for prompt evaluation and intervention when pulmonary artery injury is suspected during cardiac surgery.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1567723"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripartum cardiomyopathy: a review of prevalence and treatment trends from an African perspective.","authors":"Kedir Negesso Tukeni, Elsah Tegene Asefa, Tamirat Godebo Woyimo, Esayas Kebede Gudina, Heidi Estner, Nikolaus Alexander Haas","doi":"10.3389/fcvm.2025.1568493","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1568493","url":null,"abstract":"<p><p>Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy that develops in women without a history of heart disease during the last trimester of pregnancy or within 6 months postpartum. It is one of the primary causes of heart failure during pregnancy, which increases peripartum morbidity and mortality. PPCM can cause significant left ventricular dysfunction, progressive heart failure, and refractory cardiogenic shock, resulting in increased maternal morbidity and mortality. Dyspnea, exhaustion, and lower extremity edema are common symptoms and are often misdiagnosed as normal postpartum changes, demanding careful assessment with echocardiography. Furthermore, diagnosis and treatment are often delayed due to insufficient awareness among healthcare providers, with varying definitions of the disease across countries. Its underlying causes remain unclear, although recent studies point to a potential prolactin-oxidative stress mechanism that might lead to potential future treatments. Clinical care follows basic heart failure management guidelines while taking medication teratogenicity into account. The prognosis varies geographically based on the level and pattern of treatment, with a considerable number of patients displaying partial recovery. The prevalence and treatment patterns of these patients in Africa, including the benefits and safety profiles of bromocriptine, are reviewed here, to identify directions in its prospective use in different forms of cardiomyopathies based on the available literature.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1568493"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of off-label direct oral anticoagulants vs. warfarin for left ventricular thrombus: an inverse probability of treatment weighting analysis.","authors":"Taha Al-Maimoony, Khairallah Al-Matari, Abdulhafeedh Al-Habeet, Nouradden Noman Aljaber, Mohamad Al-Marwala, Salah Al-Hashmi","doi":"10.3389/fcvm.2025.1465866","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1465866","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of using off-label direct oral anticoagulants (DOACs) compared to warfarin for treating left ventricular (LV) thrombi using inverse probability-of-treatment weighting (IPTW) analysis.</p><p><strong>Methods: </strong>An observational study of 302 eligible patients with newly diagnosed LV thrombi was conducted at a tertiary referral center from January 2020 to December 2023. Of the 302 patients, 183 received treatment with DOACs, while 119 were treated with warfarin. The primary endpoint was defined as the complete resolution of the thrombus within one month. The secondary endpoints were defined as the complete resolution of the thrombus within six months along with the following events, including minor and major bleeding events, a systemic embolism, transient ischemic attack, stroke, and all-cause mortality. Alongside individual endpoints, a composite endpoint involving ischemic stroke or mortality was also examined.</p><p><strong>Results: </strong>IPTW estimates suggested that DOACs were significantly more effective than warfarin in resolving LV thrombus within one month (RR: 1.38; 95% CI: 1.14-1.66; <i>p</i>-value: <0.001). However, there were no significant differences between the two groups in all secondary endpoints, except that DOACs were significantly associated with a lower incidence of the composite outcome of ischemic stroke and all-cause mortality (RR: 0.96; 95% CI: 0.93-0.99; <i>p</i>-value: 0.040). In DOAC subgroup analysis, only rivaroxaban demonstrated earlier and superior resolution of LV thrombus with non-inferior safety when compared to warfarin.</p><p><strong>Conclusions: </strong>DOACs, specifically rivaroxaban, could be a promising therapeutic alternative for treating LV thrombi. Further research through randomized clinical trials is necessary to confirm our findings.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1465866"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From knowledge silos to integrated insights: building a cardiovascular medication knowledge graph for enhanced medication knowledge retrieval, relationship discovery, and reasoning.","authors":"Hongzhen Cui, Xiaoyue Zhu, Wei Zhang, Meihua Piao, Yunfeng Peng","doi":"10.3389/fcvm.2025.1526247","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1526247","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases are diverse, intersecting, and characterized by multistage complexity. The growing demand for personalized diagnosis and treatment poses significant challenges to clinical diagnosis and pharmacotherapy, increasing potential medication risks for doctors and patients. The Cardiovascular Medication Guide (CMG) demonstrates distinct advantages in managing cardiovascular disease, serving as a critical reference for front-line doctors in prescription selection and treatment planning. However, most medical knowledge remains fragmented within written records, such as medical files, without a cohesive organizational structure, leading to an absence of clinical support from visualized expert knowledge systems.</p><p><strong>Purpose: </strong>This study aims to construct a comprehensive Expert Knowledge Graph of Cardiovascular Medication Guidelines (EKG-CMG) by integrating unstructured and semi-structured Cardiovascular Medication Knowledge (CMK), including clinical guidelines and expert consensus, to create a visually integrated cardiovascular expert knowledge system.</p><p><strong>Methods: </strong>This study utilized consensus and guidelines from cardiovascular experts to organize and manage structured knowledge. BERT and knowledge extraction techniques capture drug attribute relationships, leading to the construction of the EKG-CMG with fine-grained information. The Neo4j graph database stores expert knowledge, visualizes knowledge structures and semantic relationships, and supports retrieval, discovery, and reasoning of knowledge about medication. A hierarchical-weighted, multidimensional relational model to mine medication relationships through reverse reasoning. Experts participated in an iterative review process, allowing targeted refinement of expert medication knowledge reasoning.</p><p><strong>Results: </strong>We construct an ontology encompassing 12 cardiovascular \"medication types\" and their \"attributes of medication types\". Approximately 15,000 entity-relationships include 22,475 medication entities, 2,027 entity categories, and 3,304 relationships. Taking beta-blockers (β) as an example demonstrates the complete process of ontology to knowledge graph construction and application, encompassing 41 AMTs, 1,197 entity nodes, and 1,351 relationships. The EKG-CMG can complete knowledge retrieval and discovery linked to \"one drug for multiple uses,\" \"combination therapy,\" and \"precision medication.\" Additionally, we analyzed the knowledge reasoning case of cross-symptoms and complex medication for complications.</p><p><strong>Conclusion: </strong>The EKG-CMG systematically organizes CMK, effectively addressing the \"knowledge island\" issues between diseases and drugs. Knowledge potential relationships have been exposed by leveraging EKG-CMG visualization technology, which can facilitate medication semantic retrieval and the exploration and reasoning of complex knowledge relationships.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1526247"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde inferior vena cava perfusion reduces the risk of acute kidney injury depending on the oxygen extraction ratio. A retrospective cohort study.","authors":"Xinyi Liao, Dan Luo, Jing Lin, Zhaoxia Tan, Jiyue Xiong, Lei Du","doi":"10.3389/fcvm.2025.1514247","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1514247","url":null,"abstract":"<p><strong>Background: </strong>Total aortic arch replacement surgery (TARS) for Acute type A aortic dissection is associated with high incidence of postoperative acute kidney injury (AKI), at least partly due to the lower body ischemia during circulatory arrest. This study aimed to evaluate whether retrograde inferior vena cava perfusion (RIVP) reduces the risk of AKI by providing oxygenated blood to the lower body.</p><p><strong>Methods: </strong>This retrospective study utilized a medical recording system to screen patients who underwent TARS from January 1 to December 31, 2019. Patients were assigned to receive antegrade cerebral perfusion (ACP) only or ACP + RIVP during circulatory arrest. The primary outcome was postoperative AKI. Oxygen delivery, consumption, and extraction ratio during RIVP were also determined.</p><p><strong>Results: </strong>Of all included 87 patients, postoperative AKI occurred in 35 (40%), of whom 23 (53.5%) were in the ACP, and 12 (27.3%) were in the ACP + RIVP (<i>P</i> = 0.013). In regression analysis, ACP + RIVP was associated with lower risk of AKI than ACP alone (adjusted OR 0.229; 95% CI 0.071-0.746). RIVP at a pressure of 22.5 ± 3.8 mmHg delivered 0.98 ± 0.34 ml/min/kg of oxygen to the lower body, and the partial oxygen pressure decreased from 359 ± 57 mmHg in RIVP blood to 64 ± 30 mmHg in returning blood. Oxygen extraction ratio was 44 ± 16%, which correlated negatively with peak postoperative creatinine levels (<i>r</i> = -0.58, <i>P</i> = 0.01) and creatinine increase (<i>r</i> = -0.61, <i>P</i> = 0.009). No correlations were found between oxygen delivery and postoperative creatinine or creatinine increase.</p><p><strong>Conclusion: </strong>RIVP may reduce the risk of postoperative AKI in a manner that depends on the tissue oxygen extraction ratio.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1514247"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state of heart failure treatment: are mesenchymal stem cells and their exosomes a future therapy?","authors":"Chengqian Chen, Wentao Zhong, Hao Zheng, Wei Zhao, Yushi Wang, Botao Shen","doi":"10.3389/fcvm.2025.1518036","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1518036","url":null,"abstract":"<p><p>Heart failure (HF) represents the terminal stage of cardiovascular disease and remains a leading cause of mortality. Epidemiological studies indicate a high prevalence and mortality rate of HF globally. Current treatment options primarily include pharmacological and non-pharmacological approaches. With the development of mesenchymal stem cell (MSC) transplantation technology, increasing research has shown that stem cell therapy and exosomes derived from these cells hold promise for repairing damaged myocardium and improving cardiac function, becoming a hot topic in clinical treatment for HF. However, this approach also presents certain limitations. This review summarizes the mechanisms of HF, current treatment strategies, and the latest progress in the application of MSCs and their exosomes in HF therapy.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1518036"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of singing on vascular health in older adults with coronary artery disease: a randomized, crossover trial.","authors":"Mehri Bagherimohamadipour, Muhammad Hammad, Alexis Visotcky, Rodney Sparapani, Jacquelyn Kulinski","doi":"10.3389/fcvm.2025.1546462","DOIUrl":"10.3389/fcvm.2025.1546462","url":null,"abstract":"<p><strong>Background: </strong>The impact of singing on cardiovascular health has not been extensively studied. The aim of this study is to investigate the effect of singing on cardiovascular biomarkers in an aging population with coronary artery disease (CAD).</p><p><strong>Methods: </strong>Participants had three study visits separated by 2-7 days, according to a randomized, researcher-blinded, crossover, controlled design: (1) a 30-min period of live singing with an in-person music therapist, (2) a 30-min period of singing along to an instructional video and (3) a 30-min rest (control). Primary outcomes included macrovascular endothelial function assessed by brachial artery flow-mediated dilation and microvascular function assessed by peripheral arterial tonometry [Framingham reactive hyperemia index (fRHI) and reactive hyperemia index (RHI)]. Heart rate variability (HRV) was a secondary outcome.</p><p><strong>Results: </strong>Sixty-five subjects (mean age 67.7 ± 0.8 years, 40% female) completed the study. Compared to control, there was an increase in fRHI for the singing video intervention (estimate: 0.54, SE: 0.19, <i>p</i> = 0.005) but not for the live singing intervention (estimate: 0.11, SE: 0.18, <i>p</i> = 0.570). There was no change in macrovascular function with either intervention. The low frequency/high frequency (LF/HF) ratio increased by 2.80 (SE: 1.03, <i>p</i> = 0.008), and the natural logarithm of high frequency (LnHF) power decreased by -0.90 ms² (SE: 0.29, <i>p</i> = 0.003) with the video (during to pre-change). When assessing post- to pre- change, the live singing intervention showed a significant change of -0.62 ms² (SE 0.29, <i>p</i> = 0.036) in LnHF power.</p><p><strong>Conclusions: </strong>Singing along to an instructional video for 30 min improved microvascular, but not macrovascular, endothelial function, in older patients with CAD. HRV changes with singing are similar to that of exercise.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier (NCT04121741).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1546462"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell cycle arrest of cardiomyocytes in the context of cardiac regeneration.","authors":"Qingling Xu, Xinhui Chen, Chunyige Zhao, Ying Liu, Jianxun Wang, Xiang Ao, Wei Ding","doi":"10.3389/fcvm.2025.1538546","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1538546","url":null,"abstract":"<p><p>The limited capacity of adult mammalian cardiomyocytes to undergo cell division and proliferation is one of the key factors contributing to heart failure. In newborn mice, cardiac proliferation occurs during a brief window, but this proliferative capacity diminishes by 7 days after birth. Current studies on cardiac regeneration focused on elucidating changes in regulatory factors within the heart before and after this proliferative window, aiming to determine whether potential association between these factors and cell cycle arrest in cardiomyocytes. Facilitating the re-entry of cardiomyocytes into the cell cycle or reversing their exit from it represents a critical strategy for cardiac regeneration. This paper provides an overview of the role of cell cycle arrest in cardiac regeneration, briefly describes cardiomyocyte proliferation and cardiac regeneration, and systematically summarizes the regulation of the cell cycle arrest in cardiomyocytes, and the potential metabolic mechanisms underlying cardiomyocyte cycle arrest. Additionally, we highlight the development of cardiovascular disease drugs targeting cardiomyocyte cell cycle regulation and their status in clinical treatment. Our goal is to outline strategies for promoting cardiac regeneration and repair following cardiac injury, while also pointing toward future research directions that may offer new technologies and prospects for treating cardiovascular diseases, such as myocardial infarction, arrhythmia and heart failure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1538546"},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cGAS-STING pathway in atherosclerosis.","authors":"Si-Yu Wang, Yu-Shan Chen, Bo-Yuan Jin, Ahmad Bilal","doi":"10.3389/fcvm.2025.1550930","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1550930","url":null,"abstract":"<p><p>Atherosclerosis (AS), a chronic inflammatory disease, remains a leading contributor to cardiovascular morbidity and mortality. Recent studies highlight the critical role of the cGAS-STING pathway-a key innate immune signaling cascade-in driving AS progression. This pathway is activated by cytoplasmic DNA from damaged cells, thereby triggering inflammation and accelerating plaque formation. While risk factors such as aging, obesity, smoking, hypertension, and diabetes are known to exacerbate AS, emerging evidence suggests that these factors may also enhance cGAS-STING pathway, which amplifies inflammatory responses. Targeting this pathway offers a promising therapeutic strategy to reduce the burden of cardiovascular diseases (CVD). In this review, we summarize the mechanisms of the cGAS-STING pathway, explore its role in AS, and evaluate potential inhibitors as future therapeutic candidates. By integrating current knowledge, we aim to provide insights for developing novel treatments to mitigate AS and CVD burden.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1550930"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in diagnosis, management, and long-term outcomes of pediatric vasovagal syncope: a comprehensive review.","authors":"Wenjing Zhu, Xueyan Bian, Jianli Lv","doi":"10.3389/fcvm.2025.1481749","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1481749","url":null,"abstract":"<p><p>Vasovagal syncope (VVS) is the most common cause of transient loss of consciousness in children and adolescents, accounting for 60%-80% of syncope cases. This review synthesizes current evidence on pediatric VVS, focusing on advances in diagnosis, management, and long-term outcomes. Through a comprehensive literature search of studies published between 2001 and 2024, we analyzed epidemiological patterns, pathophysiological mechanisms, diagnostic approaches, management strategies, and prognostic factors. Recent diagnostic advances include implantable loop recorders and smartphone applications, which have improved diagnostic accuracy. Management has evolved toward individualized approaches, emphasizing non-pharmacological interventions (hydration, salt supplementation, physical counterpressure maneuvers) as first-line treatment, with medications such as midodrine and fludrocortisone showing variable efficacy in refractory cases. Long-term studies indicate that while most children experience improvement over time, 33%-50% have recurrent episodes within three years, with factors such as lower mean arterial pressure, higher urine specific gravity, younger age, family history of syncope, and lower body mass index associated with increased recurrence risk. Though generally benign, VVS can significantly impact quality of life and carries substantial psychosocial consequences. Future research should focus on developing predictive models for recurrence risk and exploring personalized treatment approaches to improve outcomes.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1481749"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}